AI used for skin cancer checks at London hospital

https://www.bbc.com/news/articles/czd3ygd7mrno

103 87 1 year ago

xenospn• 1 year ago

Why go to the hospital at all? Just take the photo at home.

harvey9• 1 year ago

Article says medical photographers take the pictures. I'd guess a future iteration will have the app direct the patient to take the pictures.

onename• 1 year ago

I assume if you get a positive response you will want to speak with doctor about it

zamadatix• 1 year ago

If the thermometer says 39 C/102 F I will want to speak with a doctor about it but that doesn't mean I want to go to the hospital every time I want my temperature checked.

I suspect it has a lot more to do with these lines:

medical photographers taking photos of suspicious moles and lesions

I.e. it might not be ready enough or validated for an average person snapping their own photo and:

The images are then transferred to a desktop computer for greater analysis before the tool determines the result

There is more to it than the phone app and it may not be packaged in a way that is currently worthwhile to distribute to home users.

Both of these (and other things) may change with time of course.

charleshn• 1 year ago

As someone with a phenotype more subject to skin cancer, I have been using an app called SkinVision for years.

From my anecdotal experience it tends to flag the same moles as dermatologists do, and they have actual dermatologists review images where the model has low confidence, so overall pretty happy with it.

Note that I am not affiliated with them in any way.

shermantanktop• 1 year ago

Looks like it’s not available in the US unfortunately.

asdefghyk4• 1 year ago

Interesting information snipped from their website .... I'm in Australia so will try it out. Yes specifically says its not available in US

About SkinVision SkinVision was founded in 2012 and provides a mobile phone application, which supports individuals with the early detection of the most common forms of skin cancer (melanoma, squamous cell carcinoma, basal cell carcinoma, and precancerous actinic keratosis). SkinVision is the first CE marked skin cancer application based on extensive clinical trials, conducted in partnership with Erasmus Medical Center (EMC) and the university clinic of Ludwig Maximilian University (LMU). Research shows the app has a sensitivity of 95% and a specificity of 78%. The SkinVision app is commercially available worldwide on iOS and Android except for a few countries, such as the United States and Canada. SkinVision is based in Amsterdam, the Netherlands.

The SkinVision Service is a Medical Device and is registered with the Australian Therapeutic Goods Administration (TGA).

ajb• 1 year ago

Because you don't know what the lighting is, what the sensor is, and what kind of shit the camera app and ISP are doing to the image without telling you

I recently tried to show some images to a vet. Something in my phone fucked up the amount of red in the image, making them useless (guess what, figuring out how much blood is present is pretty important for medical applications)

Probably at some point we will all have a separate medical camera with specified response and with a specified led illuminator. Apple will probably get their phone certified in some medical camera mode. Right now I don't think phone cameras can be trusted

Not all applications need accurate colour, (no idea about cancer checks) but some really do.

darrenf• 1 year ago

4 years ago I had my partner take photos of moles that had changed colour on my back. I used the MySkinDoctor app https://www.myskindoctor.co.uk/ to send them to my consultant dermatologist (who, at the time, I had never met -- having just moved to a new area). Upon review they arranged for an in-person appointment and I was seen within a week or so. All through the NHS.

So yes, taking the photo at home is perfectly doable. I still went to hospital though.

graemep• 1 year ago

I develop the backend for that. Nice to hear it worked well for you.

ipsum2• 1 year ago

Google announced this in 2021, but never released it AFAICT: https://blog.google/technology/health/ai-dermatology-preview...

stubish• 1 year ago

One of the problems with these sorts of machine learning applications, including this exact use case elsewhere, is that they have been extremely sensitive to the imaging equipment used. Train it on a dataset of images from one source and it is only accurate on images from that source. Possibly only accurate on images from the exact same device. For home use, it needs a huge training set of images taken by all sorts of devices in all sorts of lighting conditions. And then the system will need to be improved until the error rates become useful.

instagib• 1 year ago

Certain skin cancer detection methods necessitate direct contact with the affected area to identify any abnormalities.

floppydiscen• 1 year ago

This would be such a beautiful use of AI

ProllyInfamous• 1 year ago

I last heard it's a pretty darn helpful tool, from a radiologist acquaintence/undergrad friend (who works from home in USA).

amarcheschi• 1 year ago

I'm attending a course with some goat professors, that aim to teach this kind of things. Chances are, given it's a small course you won't produce anything of real value, but the aim should be to analyze 3 datasets from 3 different neurodegenerative diseases, find some common markers and eventually make a ml model to better diagnose people with these diseases. It's not exactly easy, but given it's a real world problem it's extremely motivating

(we've been also allowed to use a university vm with 3tb of ram and that's nice)

andy994• 1 year ago

No, it's a horrible use, relying on something entirely unreliable to make medical diagnoses. All the AI safety people who pretend to worry about killer robots or whatever should actually be up in arms about these kind of uses, but you can see where actual priorities lie.

The best use of AI in medicine would be to automate away administrative bloat to let people get proper medical care.

jxjnskkzxxhx3• 1 year ago

What if it was really reliable? Would you still be against it?

andy994• 1 year ago

   99% accuracy in diagnosing benign case

This is meaningless. The only thing that matters in this kind of application is false negative rate at some acceptable false positive rate.

I assume whoever is working on this knows that, so this is mostly a criticism of the article. That said, this is a horrible use of AI.

greazy4• 1 year ago

I went searching for more. The tool is called DERM by Skin Analytics. They have more info on stats:

https://skin-analytics.com/ai-pathways/derm-performance/

A few peer reviewed pubs down the bottom of the page

frereubu2• 1 year ago

What do you mean by this being a "horrible" use of AI? (Although as another commenter has mentioned, this should more properly be called ML).

jampekka• 1 year ago

It's quite easy to correctly classify 100% of benign cases as benign.

flir2• 1 year ago

Not really. It allows you to order your cases from most-likely to least-likely, and get human eyeballs on the most-likely cases first.

potatoman222• 1 year ago

This is how most ML in healthcare is used. It's a fantasy to think we can give all patients equal attention, so it often makes sense to prioritize those most at risk. Of course no model is perfect, but ML can be very beneficial when used in the right context (i.e. not like United Healthcare).

Spooky232• 1 year ago

It’s really all about the protocol. AI tends to spot things that doctors don’t, and vice versa. Dermatology is also an area being pillaged by private equity and access is poor for many people.

I lost my wife to melanoma. She noticed a lesion within days of it appearing, and a doctor saw it within 48 hours and felt it was benign. My wife didn’t accept it and had a plastic surgeon remove it and biopsy, then had a margin removed by surgical oncologist, the standard of care at the time. It came back as a brain tumor 4 years later and she was gone in 6 months, even with the incredible advancements today.

So I’d hold the position strongly that anything that improves overall detection rates and access to care is incredibly important and will save lives. Weeks matter with melanoma. Today with immunotherapy Molly would be fine. But if she hadn’t advocated and gotten the original thing removed, it would have cost her 4 important years.

tomcam• 1 year ago

So sorry, brother.

asdefghyk4• 1 year ago

I've been told the only way to be sure if skin cancer or not , is a biopsy. I also have been told ... not skin cancer... but Dr decided to send me to a dermatologist. Is thing he said when say it .. is looks like skin cancer ... lets take a biopsy now ... to check . It was skin cancer ... a BCC

osn93637392• 1 year ago

Dude that sucks mate. I had a melanoma taken off last year. It was dormant (stage 0) but had been there for 10ish years. But reading shit like this reminds me that even though I'm probably fine, all I can do is just live my best life. Hang out with my family. Enjoy the things I enjoy and not think about it too much. (and get my skin checks every 6 months :D)

kennyadam2• 1 year ago

Similar story: mom had a melanoma removed from her foot. multiple lymph node biopsies and other tests said it had been successfully removed.

She went back once a year for checks for 4-5 years. It was only when she was called into see an oncologist and told an unrelated x-ray lead them to discover she had stage 4 metastatic melanoma (brain, liver, spine, femur, lungs and i’m sure i’m forgetting something) that we found out that they’d only been giving her visual checkups each year, no PET scans or anything else. The oncologist was shocked that the checks were so basic, mom didn’t know she was supposed to have anything else and she was dead in about 8 weeks.

We were told that the form of melanoma only came back like that in 1% of patients and usually simple visual checkups were enough. I have no idea how true that is.

potatoman222• 1 year ago

It's trendy to say "it's horrible to use AI for this" without giving specific reasons. Some reasons it could be good to use AI here:

- this can prioritize urgent patients for the severely overworked doctors

- medical error is a leading cause of death, this serves as a second-opinion (97% true-positive rate and 79% true-negative rate)

- it can be used as evidence by a nurse or physician advocating for a patient's treatment

degamad• 1 year ago

The only thing that matters in this kind of application is false negative rate at some acceptable false positive rate.

It sounds like they are inverting the scenario here. The question is not "do you have skin cancer?", it's "can you safely go home without seeing a doctor?".

For this new question, we set the acceptable false positive rate to zero (we never want to send a real cancer case home), and determine the false negative rate (we accept that some benign cases will be seen by a doctor).

The reason for the interest in identifying benign cases, rather than trying to identify the positive cases, is that it improves the situation for everybody: benign cases identified by AI are sent home almost immediately, everyone else has a shorter waiting time, so benign false negatives can be assessed more quickly by the doctor and given the all clear, and more time is now available for spending with the real cancer cases.

The numbers they're citing are 7000 cases with 5% real, so 350 real cancer, 6650 benign. If we can accurately say that 6500 of those benign cases are benign without wasting the doctors' time, then we're down to only 500 people needing to see a doctor, which is a huge improvement for everyone.

NoPicklez• 1 year ago

I don't think its a horrible use of AI at all, in fact it seems like a fairly good use case.

It's a tool that can be used in amongst the current methods to help detect skin cancer, it shouldn't be used at the only method.

greazy4• 1 year ago

This is ML. I guess AI term can apply here but I think it's a bit disingenuous to advertise as such. People will conflate the term with llm chat bots.

https://skin-analytics.com/wp-content/uploads/2024/06/Artifi...

verst• 1 year ago

What is AI to you? Neural nets only? LLMs?

I still have my textbook from almost 20 years ago: "Artificial Intelligence: A modern" by Peter Norvig. Lots of topics covered as AI there that surely do not meet your definition.

consp• 1 year ago

AI is buzzword bingo and has been since introduced to computing in the 60's.

Just clasify the method used as what it is to a supposedly educated crowd. There is no need to classify a marketing term. And yes, for that book it's also just marketing.

greazy4• 1 year ago

I've relented, I accept now that AI is an umbrella term to represent many different methods, algorithms and technologies.

Modern day usage of AI is heavily conflated with generative AI such as LLMs and Text-to-* generation systems.

My preference, as someone who works in a very closely relate field to the article, is that science should stay away from non-specific terms like AI. I've had my director approach me seeking grant ideas on using AI. It didn't go down very well when I suggested we should try to use image recognition to automate data entry. That seemed 'old', they wanted a chat bot to do... something.

ircshotty• 1 year ago

Anecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared.

When I came back to Australia, it was checked and immediately removed as an obvious melanoma.

Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?

frereubu2• 1 year ago

Being a pasty Brit, going to Australia was a real eye opener in how much more on the ball they were about skin cancer, not just in medical terms but culturally. We're getting better here (I was there more than a decade ago) but it's still seen as quite amusing when people get sunburnt here.

femto• 1 year ago

Awareness started in the 1980s in Australia with Sid the Seagull:

https://www.youtube.com/watch?v=tGgn5nwYtj0

https://www.abc.net.au/btn/classroom/sun-safety-campaign/103...

qq66• 1 year ago

Sadly, a friend of mine died from this type of problem. He traveled from Ghana to Jordan and fell ill in Jordan, the Jordanian doctors didn't diagnose it as malaria in time to save him because Jordan doesn't have malaria. I'm sure it would have been obvious to a Ghanaian doctor.

Scoundreller2• 1 year ago

Friend did a lot of work in Africa. Got back to the US and starts getting symptomatic and says to himself “I think I got malaria”.

Goes to the biggest university hospital nearby he can find.

Was initially dismissed but waited it out for the infectious diseases specialist and they quickly agreed with his self-diagnosis.

They kept them in hospital for a few days so a parade of clinical students/residents could come by for the specialist to say: “this man has malaria”

1shooner• 1 year ago

When I first heard the clinical idiom "When you hear hoof-beats, think horses not zebras" I thought it was a precautionary saying about the bias toward assuming the familiar. But it's meant to be instructive!

nneonneo• 1 year ago

A good family friend caught abdominal TB while abroad, came back to Canada, and was terribly misdiagnosed. TB is very rare here; abdominal TB even more so, and early symptoms look like a lot of other diseases. It took several hospital visits before the doctors realized the actual problem. He very nearly died, and spent nearly a year in the hospital recovering from a parade of complications.

asdefghyk4• 1 year ago

Australia, Queensland, Brisbane has the highest incidence of skin cancer in World. So Drs and dermatologists would have more experience detecting it here. UV is probably much less intense in England . This link graph shows skin cancer is over 2x in Australia https://www.statista.com/statistics/1032114/countries-with-t...

_kb• 1 year ago

Queenslander here. There’s also a fairly well equipped imaging centre that’s being testing this form of diagnosis for 5 years: https://acemid.centre.uq.edu.au/research/cre-skin-imaging-an...

markdown• 1 year ago

Australia, Queensland, Brisbane

OT but what an odd way to address a place. I know it's called down under but not everything there is back to front.

Tade0• 1 year ago

It's even more granular than that.

My neighbour who is a doctor moved to another city because that's where he managed to get a spot to train for his field.

It appears that he's learning much more there than he would back home because in this country some procedures are rare outside of his current location.

TulliusCicero• 1 year ago

Reminds me of that South Korean trauma surgeon who trained in the states and has pushed for Korea to get US-style trauma centers.

Dude got plenty of experience dealing with gunshot wounds, which probably helped him when that one North Korean defector came over the border, riddled with bullets (you may have heard this story, it was big news at the time). The especially weird coincidence was that the surgeon's mentor from the states was in Korea at the time this happened, what are the odds.

https://abcnews.go.com/International/doctor-north-korean-def...

_carbyau_• 1 year ago

Speaking with some 70 year olds, their opinion on the "best doctor in town for skincare" was basically a doctor who'd simply cut out whatever you like and send it for a biopsy.

At most you had to deal with a stitch or two but often only a bandaid. Nowadays the hydrocolloid bandages seem magic.

fasd1412• 1 year ago

Australia has high skin cancer so it's not suprised that doctors there are best in this area.

asdefghyk4• 1 year ago

My experience - Having had at least 10 skin cancers cut out over the last 30 ish years, is the only way that it can definitely be determined ( skin cancer or not ) is a biopsy.

timewizard• 1 year ago

The hospital gets about 7,000 urgent skin cancer referrals each year, but only 5% turn out to be cancer.

It seems to be that you could be doing a _much_ better job of filtering this pipeline before it gets to this point. How can so many _urgent_ cases end up being negative?

They're using AI to solve a problem that probably shouldn't exist.

RobinL• 1 year ago

The referral is just because a non expert can't be sure. The cost of the referral is relatively small, but the cost of getting it wrong is large.

Someone I know recently had a referral - it's pretty light touch, you just get a prompt appointment, and they do a minor op to remove the mole, and send it to the lab for testing. Luckily in their case, it wasn't cancer. But nothing in the process seemed weird, it was just the way of the GP escalating it because they couldn't be sure. Hypothetically, if the AI had been able to diagnose with higher certainty than the GP, all of this could have been avoided, so definitely room for improvement.

alistairSH4• 1 year ago

Do all cases in the UK start with a GP? No ability to go straight to a dermatologist? And are all dermatologists based out of hospitals?

In the US, we'd just go straight to a dermatologist, who would either remove it on the spot, or for a location that's liable to scar badly, refer to a specialist surgeon. For somebody fair skinned with lots of sun damage like myself, it's an annual "ritual".

alistairSH4• 1 year ago

And why are skin cancers being referred to a hospital at all?

Personal experience in the US... treatment can be done on the spot at the primary dermatologist's office (curettage usually) or referred either to a Mohs specialist or a plastic surgeon (both of whom usually treat at their office). Short of a melanoma that's progressed/metastasized, I don't think I've ever heard of a skin cancer being treated at a hospital (not saying it doesn't happen, only that that would be an exception, based on personal/family/friend experiences).

pixl97• 1 year ago

I don't really know anything about the UK medical system, but my guess is comparing it with how the US works isn't a good fit.

Just doing a quick google search on dermatologists in the UK mostly pointed at hospitals that offered the service, so may have something to do with that.

jgerrish• 1 year ago

And why are skin cancers being referred to a hospital at all?

I'm working on deciphering the Google Mock API right now. It's just one of those fucking things you do, you know? Figuring out how to set expectations on parameters, etc. Hundreds of thousands of SDEs and students went through it before it became second nature.

I dream of playing around with some future testing language where I can build mock blocks in a Scratch-like manner. Awesome, eh?

Fuck yeah, Alan Kay.

Maybe I could work on the team that builds it.

But who am I kidding? I get to be pushed into other work while I waste time to filling out unnecessary tax paperwork.

Because to get more medical lab work done, I need to have authentic IRS transcripts.

A written 1040 isn't enough.

Otherwise I have to go to the hospital to get imaging.

It wasn't necessary. Signed fully electronic non-forgible IRS forms for health purposes could have been done with minimal citizen pushback.

With, and this is key, an educated public who understood the economics.

So I'll work on wasting my time educating loved ones on the economics of paper-less forms and all forms of monopolies while I say no to future shows in Chicago or Canada or wherever.

rplnt• 1 year ago

This doesn't seem like nothing new? I remember a talk about this being done some 12+ years ago. Just without the AI label to generate hype.

Legend2440• 1 year ago

There has been talk about this pretty much since CNNs got good at object recognition ~2012.

But healthcare is a rather conservative industry (for good reason) so it has taken a while to build confidence in the technology and get regulatory approval.

osn93637392• 1 year ago

Yeah - I don't recall which company (maybe johnson & johnson) it was but my aunt worked for one that produced a portable machine that used a camera to check moles and used some sort of algorithm to give a predicted score. This was 20ish years ago. I remember she brought it to my grandparents and we had fun checking everyones moles for the day.

madduci• 1 year ago

This reminds me of Machine Learning techniques being used at the Policlinico of Bari in collaboration with the Politecnico of Bari, detective cancer, more than 10 years ago

lamename• 1 year ago

"At the moment that technology is limited because you need a dermoscopic lens which the public wouldn't necessarily have access to, but I'm sure with time the technology will advance and we will have effective apps that patients can access from the comfort of their own home."

AI used for skin cancer checks at London hospital

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